Showing 701 - 710 of 849 annotations tagged with the keyword "Doctor-Patient Relationship"

Annotated by:
Holmes, Martha Stoddard

Primary Category: Literature / Fiction

Genre: Novel

Summary:

When Ruth's unfaithful and unappreciative husband Bobbo calls her a she-devil, she decides to appropriate that identity with a vengeance and take a different spot in the power relations of the world. She wants revenge, power, money, and "to be loved and not love in return"(49). Specifically, Ruth wants to bring about the downfall of her husband's lover, Mary Fisher, a pretty, blonde romance novelist who lives in a tower by the sea and lacks for neither love nor money nor power.

Ruth commences her elaborate revenge by burning down her own home and dumping her surly children with Mary and Bobbo. She continues on a literally shape-shifting quest in which she changes identities; gains skill, power, and money; and explores and critiques key sites of power and powerlessness in contemporary society, including the church, the law, the geriatric institution, the family home, and (above all) the bedroom.

By the end of the novel, Ruth achieves all four of her goals in abundance. Her success, however, raises complex ethical questions, not only because she uses the same strategies of manipulation and cruelty of which she was a victim, but also because of the painful physical reconstruction of her body that is the tool of her victory.

View full annotation

Rich Men Tend to Be Strange

Klíma, Ivan

Last Updated: May-10-2000
Annotated by:
Miksanek, Tony

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

Alois Burda loves money. He is a wealthy owner of a car dealership who has many acquaintances but no true friends. He has been married twice and has three children but is uninterested in his family. Prior to his sixtieth birthday, he experiences weight loss, abdominal pain, and night sweats. Burda is diagnosed with inoperable metastatic cancer of the pancreas.

He seems worried most about what to do with his property and money. Before entering the hospital, he hides his money in some old slippers until he can decide what to do with it. He is comforted by a young nurse, Vera, whose voice reminds him of his mother's. After he dies, Burda's wife discards her husband's belongings into a heap of rubbish, unaware of the fortune hidden in his slippers.

View full annotation

Summary:

The spoiled Long Island heiress, Judith Traherne (Bette Davis) is suffering from severe headaches and visual disturbances, which she tries to ignore in pursuit of wild parties and frenetic horse-back riding. Her friend and secretary, Ann (Geraldine Fitzgerald), and the old family doctor bring her to Dr. Frederick Steele (George Brent). Steele has just sold his neurosurgical practice and is about to catch a train to Vermont where he will devote himself to fulltime research on malignant brain tumors. He delays his departure to operate successfully on Judith's glioma.

He and his patient fall in love. But Steele learns that her disease will recur in a predictable manner: blindness followed by painless death. He and Ann conspire to hide the prognosis from Judith. A wedding is planned and the move to Vermont. But Judith uncovers the secret and flies into a rage at the treachery, breaking off the engagement.

She tries to drown her sorrow of impending doom in drink, a frivolous dalliance with a drunken suitor (Ronald Reagan), and a more serious dalliance with her horse-trainer, Michael (Humphrey Bogart). On the verge of sin with Michael, she realizes that her only hope lies in life itself, marriage and the house in Vermont. Steele conducts his laboratory research in a back shed and the couple carry on as if her death sentence did not exist.

Living a lie provides their few months of happiness, their "Dark Victory," Judith says, over the cruel promise of her death. Just as Steele is invited to New York to present his research, her vision begins to cloud and fade. She tells Ann, but keeps the news from her husband. He leaves the now blind Judith and her friend in the garden planting bulbs that will bloom in spring. She sends Ann away too, and lies down to face her romantic (but painless) end alone.

View full annotation

Annotated by:
Shafer, Audrey

Primary Category: Literature / Nonfiction

Genre: Diary

Summary:

Gottlieb, nearing thirty years old, discovered her childhood diaries in a closet in her parents' home as she searched for some chemistry notes to aid in her quest to attend medical school. This book is "based on diaries" she wrote when she was diagnosed with and underwent treatment for anorexia nervosa. It is the writing of a precocious, strong-willed preteen who enjoys chess, being unique, writing, and getting straight A's in school, yet who is lonely and desperate to fit in and be popular.

Lori is eleven years old, lives in Beverly Hills, California with her fashion-conscious, loves-to-shop mother, her somewhat distant stockbroker father, her older brother David who now is into music and friends and not-Lori, and her best friend Chrissy, a pet parakeet. Lori's diary entries are filled with astute observations of adults (teachers, parents, relatives, medical personnel, even a television star she meets, Jaclyn Smith) and classmates.

She is wry and witty. An early entry gives an English essay she rewrote to get an "A". These "power paragraphs" are generously and hilariously sprinkled with "proper transitions" such as "to begin with", "moreover", and "on the other hand" that her teacher insists are necessary for readability. This essay provides telling insights about Lori's perceptions of her family, particularly (note transition word) her mother's superficiality.

Lori is surrounded by messages of the glories of thinness for women. Every female she encounters, from peer to adult, is on a diet, counts calories, avoids desserts and gossips about how other women and girls look. The culture is not only anti-obesity, but pro-superthinness. Hence it is logical that Lori, angry about being taken from school to go on a family trip to Washington, D.C., begins her rebellion and search for control by skipping meals and dieting.

She gets the attention she craves from her parents. Her schoolmates ask her for diet advice and admire her weight loss. Self-denial, obsession with calories (that she believes can even be gained by breathing), and secret exercising lead to an alarming weight loss in this already skinny kid.

Her mother takes her to the pediatrician, who prescribes whole milk which Lori refuses. He refers her to a psychiatrist, who eventually hospitalizes her for behavior modification, observation, and a possible feeding tube. At the hospital, Lori meets medical students, nurses and fellow patients, but becomes progressively more depressed, dehydrated and lonely. She attempts to run away and makes a suicide gesture. Finally, she sees herself for what she has become--an emaciated stick figure.

View full annotation

Annotated by:
Shafer, Audrey

Primary Category: Literature / Nonfiction

Genre: Treatise

Summary:

The author, a Canadian physician-historian-educator, blows the dust off the shelves of medical history with this fascinating text designed for medical students, educators, and those with an interest in history of medicine. Duffin begins this survey of the history of Western medicine with a glimpse at a pedagogical tool designed to spark the interest of even the most tunnel visioned medical students: a game of heroes and villains. In the game, students choose a figure from a cast of characters selected from a gallery of names in the history of medicine.

Using primary and secondary sources, the students decide whether the figures were villains or heroes. The winner of the game is the student who first recognizes that whether a person is a villain or hero depends on how you look at it. This philosophy imbues the entire book, as this treatise is not a tired litany of dates, names and discoveries, but rather a cultural history of the various times in which medical events occurred.

The book is organized by topics which roughly follow a medical school curriculum: anatomy, physiology, pathology, pharmacology, health care delivery systems, epidemiology, hematology, physical diagnosis and technology, surgery, obstetrics and gynecology, psychiatry, pediatrics, and family medicine. The last chapter, entitled "Sleuthing and Science: How to Research a Question in Medical History," gives guidance to formulating a research question and searching for source material. Fifty-five black and white illustrations are sprinkled throughout the book, as well as 16 tables.

Direct quotes from historical figures, such as Galen and Laennec, as well as excerpts from writings of eyewitnesses of events, anecdotes and suggestions for discussion, appear in boxes within the chapters. Many of the chapters contain discussion about the formation of professional societies. Each chapter ends with several pages of suggested readings and the third appendix delineates educational objectives for the book and individual chapters. The other two appendices list the recipients of the Nobel Prize in Physiology or Medicine, and tools for further study, including titles of library catalogues, and resources in print and on-line.

Although the book is a survey covering multiple eras and topics, each chapter contains choice tidbits of detail. For instance, the chapter on obstetrics and gynecology includes the story and photograph of Dr. James Miranda Barry, the mid-nineteenth century physician, surgeon and British military officer, who was discovered to be a woman at the time of her death. The impact of the stethoscope on the practice of medicine is explored in depth in the chapter, "Technology and Disease: The Stethoscope and Physical Diagnosis."

View full annotation

Summary:

This posthumously published collection of essays by Dr. Klawans, an eminent neurologist and writer, explores the interactions between patient, family and neurologist and the implications of specific neurologic diseases. Klawans's special interest in neurology is movement disorders, such as Huntington's chorea and Parkinson's disease, but his outside interests range from evolutionary biology to classical music. His essays, therefore, focus on single patients or families, but the author weaves thoughts about his other interests into each "case."

The book is divided into two sections, "The Ascent of Cognitive Function" and "The Brain's Soft Spots: Programmed Cell Death, Prions, and Pain." In a brief preface, Klawans declares that this book is "more than just a set of clinical tales about interesting and at times downright peculiar patients" from his 35 years of practice, but rather it "humbly grapples with the 'whys' of our brain, not the 'hows.'" (pp. 9-10) In the preface, as well as in one essay, Klawans acknowledges the work and impact of fellow neurologist-writer Oliver Sacks ("Oliver is truly the father of us all." p 12).

The title essay concerns a six-year-old girl who was found, locked and completely speech-deprived, in a closet. Because she is still within the window of opportunity for language acquisition, "Lacey" quickly learns to speak, unlike Victor, the Wild Boy of Aveyron, whose story was immortalized in the François Truffaut film, L'enfant Sauvage. Klawans uses these stories as a launch pad to discuss the evolution of language, including a proposal that the cavewoman, not the man, was responsible for development of the human species as she taught her offspring language.

Other chapters focus on patients with epilepsy, Parkinson's disease, localized and hemispheric stroke, "painful-foot-and-toe syndrome, " and Creutzfeldt-Jakob disease. Two particularly memorable chapters concern Huntington's chorea and Refsum's disease. The chapter, "Anticipation," explores the profound ethical concerns of genetic testing for Huntington's chorea as applied to three generations of one particular family. In the chapter, "The Hermit of Thief River Falls," Klawans recollects his first year as a neurology resident, and his care of a reclusive patient with a rare eponymous illness, Refsum's disease--just in time for a visit by Refsum himself, a famous Norwegian neurologist.

The book concludes with a speculative "afterthought" about genetics, evolution, and the importance of extended "juvenilization" --the protracted post-natal development of Homo sapiens. This essay intertwines some of the threads regarding speech development and evolutionary biology, particularly brain development, that were introduced earlier in the text.

View full annotation

Annotated by:
Coulehan, Jack

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

The author of this memoir is a poet and writer who developed systemic lupus erythematosis (SLE) during her first year at the University of Pennsylvania. Initially, her condition was difficult to diagnose, which led to her first negative encounters with physicians and the health care system. Later, Ms. Goldstein developed unusual neurological manifestations of SLE. Once again, she had trouble convincing her doctors that her symptoms were not only real, but also disabling. She was fortunate enough to come across a few good physicians who respected her as a person and earned her trust.

Despite her chronic illness, Ms. Goldstein thrived throughout college and graduate school. She approached each new challenge with such a positive attitude that some of her doctors considered her emotionally unstable. (I guess they thought it would be more "normal" for her to lose hope and turn herself into an invalid.) Her graduate work in literature focused on the new field of literature and medicine.

View full annotation

Bruno

Novakovich, Josip

Last Updated: Feb-29-2000
Annotated by:
Miksanek, Tony

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

Bruno Kamenar is a pale and thin ten year old boy who lives with his stepmother and younger brother in Croatia in 1948. His father, Pero, has just returned home after serving in the Yugoslav Federal Army. With the constant threat of a Soviet invasion serving as a backdrop, Bruno is plagued by frequent nightmares as well as a cough. He finds solace both in drawing and in the company of the family cow.

Sadly, Bruno contracts tuberculosis from the cow's fresh milk. At first he is unable to be treated because the government rejects an offer of free streptomycin from the Swiss. It is only after Pero publicly criticizes his country's refusal of medical aid and becomes a political prisoner that UNICEF physicians arrive at Bruno's home and treat him with streptomycin and PAS.

He recovers and his father is released from prison. As he watches the family cow and its pen incinerated, Bruno is filled with horror and relief by the death of an animal that once provided food and comfort but almost killed him.

View full annotation

The Mind is Not the Heart

Salber, Eva

Last Updated: Feb-07-2000
Annotated by:
Willms, Janice

Primary Category: Literature / Nonfiction

Genre: Autobiography

Summary:

In this extensive review of her experiences in public health and rural and urban medicine, Eva Salber, MD, explores the commonalities and the differences in medical practice among three environments: pre-World War II South Africa, urban America, and the hills of North Carolina. Trained in South Africa, where she and her husband practiced for many years, Salber came to the US during a very difficult political period for whites in Cape Town.

In Boston, she pursued her passion for the plight of the poor and their health issues by studying further public health and running a ghetto clinic. Later, as a member of the Duke University faculty, she established rural health clinics in North Carolina. She describes, in this memoir, the contrasts among the cultures as well as her own difficulty in obtaining the funding and support she needed to carry out her work in each setting.

View full annotation

Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Nonfiction

Genre: Essay

Summary:

The writer describes her experience as a cancer patient, thrust into "the Land of the Sick" by the diagnosis and treatment of lung cancer four years earlier. Although she is not ill, the fear of mortality embedded in a diagnosis of cancer is a dragon that haunts her existence.

To cope with the dragon she relies on talismen: her doctors, personal will, and her garden peas, an emblem of everyday life and its constant renewal. The talismen create the semblance of control over her situation. She observes that "doctors and patients are accomplices in staging a kind of drama" and that the patient and her continued well-being become talismen for the doctor too.

View full annotation